Solbiati L, Ierace T, Goldberg S N, Sironi S, Livraghi T, Fiocca R, Servadio G, Rizzatto G, Mueller P R, Del Maschio A, Gazelle G S
Department of Radiology, General Hospital, Busto Arsizio (VA), Italy.
Radiology. 1997 Jan;202(1):195-203. doi: 10.1148/radiology.202.1.8988211.
To determine the potential efficacy of radio-frequency (RF) ablation of liver metastases during long-term follow-up.
Sixteen patients with 31 hepatic metastases were treated with percutaneous, ultrasound-guided RF ablation. RF was applied to monopolar electrodes (2-3-cm tip exposure) either individually or within a multiprobe array (two to four probes) for 6 minutes at 90 degrees C over one to four treatment sessions per metastasis.
In only one of 75 sessions, a moderate complication, self-limited intraperitoneal hemorrhage, was observed. Four patients (four lesions) underwent surgical resection 15-60 days after RF treatment. Residual, viable tumor was seen in all of these patients. The remaining 12 patients were followed up for 9-29 months (mean, 18.1 months). In these patients, 18 of 27 lesions remained stable or decreased in size and showed no enhancement at computed tomography and/or magnetic resonance imaging for at least 9 months. Two patients died of disseminated disease at 13 months and one at 16 months. Disease-free survival was achieved in eight patients.
RF ablation appears to be a simple, safe, and potentially effective treatment for selected patients with liver metastases and may become a less invasive alternative to surgical therapy.
确定在长期随访期间射频（RF）消融肝转移瘤的潜在疗效。
16例患者共31个肝转移瘤接受了经皮超声引导下的RF消融治疗。将RF应用于单极电极（尖端暴露2 - 3厘米），单个电极或在多探头阵列（2至4个探头）内使用，每个转移瘤进行1至4次治疗，每次治疗在90摄氏度下持续6分钟。
在75次治疗中仅观察到1次中度并发症，即自限性腹腔内出血。4例患者（4个病灶）在RF治疗后15 - 60天接受了手术切除。所有这些患者均可见残留的存活肿瘤。其余12例患者随访9 - 29个月（平均18.1个月）。在这些患者中，27个病灶中的18个病灶大小保持稳定或缩小，在计算机断层扫描和/或磁共振成像上至少9个月无强化。2例患者分别在13个月和16个月死于播散性疾病。8例患者实现了无病生存。
对于部分肝转移瘤患者，RF消融似乎是一种简单、安全且潜在有效的治疗方法，可能成为手术治疗的一种侵入性较小的替代方案。
